EM final test questions example
1. A 12-year-old boy presents to the emergency department after falling off his bicycle. He landed on his outstretched hand
and now complains of severe pain in his left forearm. On examination, his left forearm shows significant swelling and
deformity. An X-ray of the forearm reveals a fracture of the radius. The fracture line is diagonal to the long axis of the bone,
and there is notable displacement of the fragments. Based on this information, which type of fracture does the patient most
likely have?
A) Transverse fracture
B) Oblique fracture
C) Spiral fracture
D) Comminuted fracture
E) Salter-Harris fracture: B) Oblique fracture.
2. What is a common indicator that injuries may be the result of intimate partner violence (IPV)?
A) Injuries that are consistent with the patient's explanation
B) A single injury that is healing
C) Injuries during pregnancy
D) Presentation for treatment immediately after an injury occurs: C) Injuries during pregnancy.
3. What is a common complication of femoral neck fractures, particularly in older patients?
A) Deep vein thrombosis
B) Avascular necrosis (AVN)/non-union
C) C) Post-operative infection
D) Pulmonary embolism: B) Avascular necrosis (AVN)/non-union.
4. A 45-year-old woman presents to her primary care physician with a 2-week history of severe shoulder pain, describing it as
incapacitating, especially at night. She has no history of trauma to the shoulder. Physical examination reveals localized
tenderness in the shoulder area. An X-ray of the shoulder shows calcium deposits in the tendons of the rotator cuff. What is
the most appropriate management for this patient?
A) Immediate surgical removal of calcium deposits
B) Prescribing NSAIDs and initiating physical therapy
C) Corticosteroid injection into the glenohumeral joint
D) High-dose oral corticosteroids for 1 week: B) Prescribing NSAIDs and initiating physical therapy.
, EM final test questions example
5. A 32-year-old woman presents to the emergency department with multiple bruises in various stages of healing across her
arms and face. She initially states she fell down the stairs a week ago but seems hesitant and avoids eye contact. Upon
further gentle questioning, she reveals these injuries occurred at different times. She is currently 20 weeks pregnant. What
are important considerations in the management of this patient that may suggest IPV?
A) Assessing for IPV in a safe, private setting and offering appropriate re-sources
B) Dismissing the injuries as accidental since she is pregnant
C) Only treating the physical injuries without further psychosocial assessment
D) D) Waiting for her to openly admit to IPV without direct inquiry: A) Assessing for IPV in a safe, private setting and offering
appropriate resources.
6. A 20-year-old male presents to the emergency department after falling during a soccer game. He reports a direct impact to
his left shoulder and now exhibits asymmetry, deformity, and tenderness along the left clavicle. Based on these findings, what
is the most appropriate initial management for this patient?
A) Immediate surgical intervention
B) Application of a shoulder immobilizer and ice, followed by analgesia
C) Placement in a long-arm gutter splint
D) Administration of IV antibiotics: B) Application of a shoulder immobilizer and ice, followed by analgesia.
7. An 80-year-old woman with a history of osteoporosis presents to the emergency department after a fall at home. She is
unable to bear weight on her left leg, which appears shortened, abducted, and externally rotated. There is notable pain in her
groin area. Hip radiographs are ordered. What is the most appropriate management plan if initial radiographs are negative but
clinical suspicion for fracture remains high?
A) Start the patient on NSAIDs and discharge with outpatient follow-up
B) Apply a hip spica cast and re-evaluate in 2 weeks
C) Order an MRI to evaluate for an occult hip fracture and consult orthopedics
D) D) Prescribe bed rest and physical therapy for presumed muscle strain: C) Order an MRI to evaluate for an occult hip fracture
and consult orthopedics.
8. A 45-year-old man presents with severe anterior knee pain after jumping during a basketball game. He reports a sensation
of a "pop" in his knee and now cannot straighten his leg or perform a straight leg raise. Examination reveals a palpable gap
proximal to the patella. What is the most appropriate management?
A) Immediate knee immobilization and referral for orthopedic consultation
B) Physical therapy focusing on quadriceps strengthening
C) Corticosteroid injection into the knee joint
D) Prescribe NSAIDs and recommend rest: A) Immediate knee immobilization and referral for orthopedic consultation.
, EM final test questions example
9. What is the imaging study of choice for diagnosing an occult hip fracture?
A) X-ray
B) CT scan
C) MRI
D) Ultrasound: C) MRI.
10. What is the mainstay of treatment for a patient with progressive signs and symptoms of a pit viper envenomation?
A) Corticosteroids
B) Antibiotics
C) Antivenom
D) Analgesics: C) Antivenom.
11. A 22-year-old male is brought to the emergency department with a core temperature of 40.5°C (104.9°F), confusion, and
seizures after collapsing during an outdoor summer sports event. Which of the following is the most appropriate initial
management?
A) Immerse the patient in ice water until the core temperature reaches 39°C (102.2°F).
B) Administer oral hydration and place in a cool environment.
C) Begin evaporative cooling and monitor cardiac status, without water immer-sion.
D) Provide antibiotics and initiate cooling blankets.: C) Begin evaporative cooling and monitor cardiac status, without water
immersion.
12. A 50-year-old farmer presents to the emergency department with symptoms of salivation, lacrimation, urination,
defecation, GI cramping, and miosis. He was spraying his crops with insecticide earlier in the day. Which of the following is
the most likely diagnosis?
A) Cholinergic toxidrome
B) Anticholinergic toxidrome
C) Opioid overdose
D) Ethanol intoxication: A) Cholinergic toxidrome.
13. A 24-year-old woman presents to the emergency department within hours after experiencing a sexual assault. She is
visibly distressed and consents to an examination and forensic evidence collection. What steps should be taken in the
immediate management and support of this patient?
1. A 12-year-old boy presents to the emergency department after falling off his bicycle. He landed on his outstretched hand
and now complains of severe pain in his left forearm. On examination, his left forearm shows significant swelling and
deformity. An X-ray of the forearm reveals a fracture of the radius. The fracture line is diagonal to the long axis of the bone,
and there is notable displacement of the fragments. Based on this information, which type of fracture does the patient most
likely have?
A) Transverse fracture
B) Oblique fracture
C) Spiral fracture
D) Comminuted fracture
E) Salter-Harris fracture: B) Oblique fracture.
2. What is a common indicator that injuries may be the result of intimate partner violence (IPV)?
A) Injuries that are consistent with the patient's explanation
B) A single injury that is healing
C) Injuries during pregnancy
D) Presentation for treatment immediately after an injury occurs: C) Injuries during pregnancy.
3. What is a common complication of femoral neck fractures, particularly in older patients?
A) Deep vein thrombosis
B) Avascular necrosis (AVN)/non-union
C) C) Post-operative infection
D) Pulmonary embolism: B) Avascular necrosis (AVN)/non-union.
4. A 45-year-old woman presents to her primary care physician with a 2-week history of severe shoulder pain, describing it as
incapacitating, especially at night. She has no history of trauma to the shoulder. Physical examination reveals localized
tenderness in the shoulder area. An X-ray of the shoulder shows calcium deposits in the tendons of the rotator cuff. What is
the most appropriate management for this patient?
A) Immediate surgical removal of calcium deposits
B) Prescribing NSAIDs and initiating physical therapy
C) Corticosteroid injection into the glenohumeral joint
D) High-dose oral corticosteroids for 1 week: B) Prescribing NSAIDs and initiating physical therapy.
, EM final test questions example
5. A 32-year-old woman presents to the emergency department with multiple bruises in various stages of healing across her
arms and face. She initially states she fell down the stairs a week ago but seems hesitant and avoids eye contact. Upon
further gentle questioning, she reveals these injuries occurred at different times. She is currently 20 weeks pregnant. What
are important considerations in the management of this patient that may suggest IPV?
A) Assessing for IPV in a safe, private setting and offering appropriate re-sources
B) Dismissing the injuries as accidental since she is pregnant
C) Only treating the physical injuries without further psychosocial assessment
D) D) Waiting for her to openly admit to IPV without direct inquiry: A) Assessing for IPV in a safe, private setting and offering
appropriate resources.
6. A 20-year-old male presents to the emergency department after falling during a soccer game. He reports a direct impact to
his left shoulder and now exhibits asymmetry, deformity, and tenderness along the left clavicle. Based on these findings, what
is the most appropriate initial management for this patient?
A) Immediate surgical intervention
B) Application of a shoulder immobilizer and ice, followed by analgesia
C) Placement in a long-arm gutter splint
D) Administration of IV antibiotics: B) Application of a shoulder immobilizer and ice, followed by analgesia.
7. An 80-year-old woman with a history of osteoporosis presents to the emergency department after a fall at home. She is
unable to bear weight on her left leg, which appears shortened, abducted, and externally rotated. There is notable pain in her
groin area. Hip radiographs are ordered. What is the most appropriate management plan if initial radiographs are negative but
clinical suspicion for fracture remains high?
A) Start the patient on NSAIDs and discharge with outpatient follow-up
B) Apply a hip spica cast and re-evaluate in 2 weeks
C) Order an MRI to evaluate for an occult hip fracture and consult orthopedics
D) D) Prescribe bed rest and physical therapy for presumed muscle strain: C) Order an MRI to evaluate for an occult hip fracture
and consult orthopedics.
8. A 45-year-old man presents with severe anterior knee pain after jumping during a basketball game. He reports a sensation
of a "pop" in his knee and now cannot straighten his leg or perform a straight leg raise. Examination reveals a palpable gap
proximal to the patella. What is the most appropriate management?
A) Immediate knee immobilization and referral for orthopedic consultation
B) Physical therapy focusing on quadriceps strengthening
C) Corticosteroid injection into the knee joint
D) Prescribe NSAIDs and recommend rest: A) Immediate knee immobilization and referral for orthopedic consultation.
, EM final test questions example
9. What is the imaging study of choice for diagnosing an occult hip fracture?
A) X-ray
B) CT scan
C) MRI
D) Ultrasound: C) MRI.
10. What is the mainstay of treatment for a patient with progressive signs and symptoms of a pit viper envenomation?
A) Corticosteroids
B) Antibiotics
C) Antivenom
D) Analgesics: C) Antivenom.
11. A 22-year-old male is brought to the emergency department with a core temperature of 40.5°C (104.9°F), confusion, and
seizures after collapsing during an outdoor summer sports event. Which of the following is the most appropriate initial
management?
A) Immerse the patient in ice water until the core temperature reaches 39°C (102.2°F).
B) Administer oral hydration and place in a cool environment.
C) Begin evaporative cooling and monitor cardiac status, without water immer-sion.
D) Provide antibiotics and initiate cooling blankets.: C) Begin evaporative cooling and monitor cardiac status, without water
immersion.
12. A 50-year-old farmer presents to the emergency department with symptoms of salivation, lacrimation, urination,
defecation, GI cramping, and miosis. He was spraying his crops with insecticide earlier in the day. Which of the following is
the most likely diagnosis?
A) Cholinergic toxidrome
B) Anticholinergic toxidrome
C) Opioid overdose
D) Ethanol intoxication: A) Cholinergic toxidrome.
13. A 24-year-old woman presents to the emergency department within hours after experiencing a sexual assault. She is
visibly distressed and consents to an examination and forensic evidence collection. What steps should be taken in the
immediate management and support of this patient?
